Safety and Efficacy of Perioperative Sublingual Tacrolimus in Pancreas Transplant Compared With Oral Tacrolimus

Patel, Neha; Perez, Caroline; Taber, David J.; Kalbavi, Vishal; Gonzales, Haley; Rohan, Vinyak

doi:10.6002/ect.2020.0391

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…after PTx remains a challenge as immunosuppression remains imperative, often requiring sublingual tacrolimus. 164 A well protocolized stepwise management of gastroparesis, including early oral intake, narcotic minimization, pharmacological therapies, and possibly pylorusdirected interventions has been advocated. 165…”

Section: Post-transplant Interventionsmentioning

confidence: 99%

“…Following PTx, improvement in symptoms of gastroparesis has been described with associated electrogastrography normalization 163 . However, the management of gastroparesis (a risk factor for frailty) after PTx remains a challenge as immunosuppression remains imperative, often requiring sublingual tacrolimus 164 . A well protocolized stepwise management of gastroparesis, including early oral intake, narcotic minimization, pharmacological therapies, and possibly pylorus‐directed interventions has been advocated 165 …”

Section: Interventions To Mitigate Frailty Pre‐ and Post‐pancreas Tra...mentioning

confidence: 99%

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Comprehensive review: Frailty in pancreas transplant candidates and recipients

Parsons

Tantisattamo

Cheungpasitporn

et al. 2023

Clinical Transplantation

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Well‐selected patients with kidney disease and diabetes mellitus who undergo simultaneous kidney‐pancreas transplantation often experience dramatic improvements in quality of life and long‐term survival compared to those who remain on medical therapy. Over the past several years the importance of frailty in the pancreas transplant candidate and recipient populations has grown. More patients with advanced age have entered the waitlist, and complications from prolonged diabetes, even in younger patients, have created increased evidence of risk for frailty. Given these concerns, and the broad challenges facing pancreas transplantation volumes overall, we generated this review to help establish the impact and implications. We summarize the interplay of immunological factors, aging, environmental factors, diabetes mellitus, and chronic kidney disease that put these patients at risk for frailty. We discuss its measurement and recommend a combination of two instruments (both well‐validated and one entirely objective). We describe the outcomes for patients before and after pancreas transplantation who may have frailty, and what interventions can be taken to mitigate its effects. Broader investigation into frailty in the pancreas transplant population is needed to better understand how to select patients for pancreas transplantation and to how manage its consequences thereafter.

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Section: Post-transplant Interventionsmentioning

confidence: 99%